[Sportschosun Jang Jong-ho] People in their 30s often overestimate their health and overlook warning signs related to blood pressure, blood sugar and cholesterol. However, a domestic research team has found that even in their 30s, having prehypertension, prediabetes and prehyperlipidemia at the same time significantly raises the long-term risk of myocardial infarction and stroke.
A research team led by Cheon Dae-young of the Department of Cardiology at Hallym University Dongtan Sacred Heart Hospital, Lee Min-woo of the Department of Neurology at Hallym University Sacred Heart Hospital, who served as co-corresponding authors, and Lee Jin-hwa and Lee Yeon-jeong of the Department of Cardiology at Hallym University Dongtan Sacred Heart Hospital, who served as co-first authors, confirmed this in a study titled "Combined Pre-Hypertension, Pre-Diabetes, and Pre-Hyperlipidemia and Long-Term Cardiovascular Risk in Young Adults: A Nationwide Cohort Study."
The team analyzed 1.74 million Koreans aged 30 to 39 who took part in the 2009 National Health Screening Program and had no prior history of hypertension, diabetes, dyslipidemia, myocardial infarction or stroke. Among them, 44,553 people who had all three conditions — prehypertension, prediabetes and borderline dyslipidemia — based on blood pressure, blood sugar and LDL cholesterol levels were compared with 452,763 people in the normal group who had none of the three preconditions.
Prehypertension was defined as a systolic blood pressure of 120 to 139 mmHg or a diastolic blood pressure of 70 to 89 mmHg. Prediabetes was defined as fasting blood glucose of 100 to 125 mg/dL, and borderline dyslipidemia was defined as LDL cholesterol of 130 to 159 mg/dL.
The researchers followed the participants for an average of 14.2 years and analyzed the incidence of myocardial infarction, stroke and cardiovascular death. As a result, the "combined precondition group" with all three preconditions had twice the incidence of major cardiovascular disease — myocardial infarction, stroke and cardiovascular death — compared with the normal group. Even after adjusting for factors such as age, sex, body mass index, smoking and drinking, the risk of cardiovascular disease was still 23% higher.
In detail, the risk of myocardial infarction was 18% higher and the risk of stroke was 35% higher, indicating that the overall increase in risk was driven by more frequent heart attacks and strokes. By contrast, there was no statistically significant difference in overall mortality or cardiovascular mortality. Subgroup analyses also showed that the increased risk in the group with all three preconditions was generally consistent regardless of body mass index, smoking or drinking status, exercise habits or lipid levels.
Lee Jin-hwa explained, "Through this study, we confirmed that even in your 30s, if blood pressure, blood sugar and cholesterol are all at precondition levels, the long-term risk of myocardial infarction and stroke increases." She added, "Because these individuals have no symptoms and have not been diagnosed with a disease, they are easily left untreated, but this shows that they are by no means in a safe zone from a long-term perspective."
Cheon Dae-young said, "Atherosclerotic cardiovascular disease begins with vascular damage decades earlier due to metabolic and hemodynamic causes, increasing lifelong cardiovascular risk and accelerating the development of asymptomatic atherosclerosis." He added, "This study is meaningful because it shows that even people in their 30s, who may be classified as a low-risk group in short-term 10-year risk assessments, may have their long-term cerebrovascular and cardiovascular risk underestimated."
Lee Min-woo said, "It is important for young people to keep blood pressure, blood sugar and cholesterol as close to the normal range as possible through weight control, quitting smoking, reducing alcohol intake, dietary management and regular exercise." He added, "Young people with overlapping precondition metabolic abnormalities need to be recognized as a high-risk 'candidate group,' and they should receive close follow-up and tailored lifestyle interventions."
Meanwhile, the findings were recently published online in the European Journal of Preventive Cardiology, the official journal of the European Society of Cardiology (ESC) and an SCIE-indexed international journal. Cheon Dae-young also presented the study as an oral presentation at the 18th Asia Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD) Congress and the 31st PLAS-PSH Joint Congress, held in Manila, Philippines, from April 8 to 10.
Jang Jong-ho, bellho@sportschosun.com
